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Validation of patient health questionnaire (PHQ) for major depression in Chinese outpatients with multiple somatic symptoms: A multicenter cross-sectional study

Xiong, Nana, Fritzsche, Kurt, Wei, Jing, Hong, Xia, Leonhart, Rainer, Zhao, Xudong, Zhang, Lan, Zhu, Liming, Tian, Guoqing, Nolte, Sandra and Fischer, Felix 2015, Validation of patient health questionnaire (PHQ) for major depression in Chinese outpatients with multiple somatic symptoms: A multicenter cross-sectional study, Journal of Affective Disorders, vol. 174, pp. 636-643, doi: 10.1016/j.jad.2014.12.042.

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Title Validation of patient health questionnaire (PHQ) for major depression in Chinese outpatients with multiple somatic symptoms: A multicenter cross-sectional study
Author(s) Xiong, Nana
Fritzsche, Kurt
Wei, Jing
Hong, Xia
Leonhart, Rainer
Zhao, Xudong
Zhang, Lan
Zhu, Liming
Tian, Guoqing
Nolte, Sandra
Fischer, Felix
Journal name Journal of Affective Disorders
Volume number 174
Start page 636
End page 643
Total pages 8
Publisher Elsevier
Place of publication Amsterdam, The Netherlands
Publication date 2015-03
ISSN 0165-0327
1573-2517
Keyword(s) Chinese
Confirmative factor analysis
Depression
Multiple somatic symptoms
Patient Health Questionnaire-9
Somatic symptom disorder
Summary Background: Despite the high co-morbidity of depressive symptoms in patients with multiple somatic symptoms, the validity of the 9-item Patient Health Questionnaire (PHQ-9) has not yet been investigated in Chinese patients with multiple somatic symptoms. Methods: The multicenter cross-sectional study was conducted in ten outpatient departments located in four cities in China. The psychometric properties of the PHQ-9 were examined by confirmative factor analysis (CFA). Criterion validation was undertaken by comparing results with depression diagnoses obtained from the Mini International Neuropsychiatric Interview (MINI) as the gold standard. Results: Overall, 491 patients were recruited of whom 237 had multiple somatic symptoms (SOM+ group, PHQ-15 ≥ 10). Cronbach's α of the PHQ-9 was 0.87, 0.87, and 0.90 for SOM+ patients, SOM- patients, and total sample respectively. All items and the total score were moderately correlated. The factor models of PHQ-9 tested by CFA yielded similar diagnostic performance when compared to sum score estimation. Multi-group confirmatory factor analysis based on unidimensional model showed similar psychometric properties over the groups with low and high somatic symptom burden. The optimal cut-off point to detect depression in Chinese outpatients was 10 for PHQ-9 (sensitivity=0.77, specificity=0.76) and 3 for PHQ-2 (sensitivity=0.77, specificity=0.74). Limitations: Potential selection bias and nonresponse bias with applied sampling method. Conclusions: PHQ-9 (cut-off point=10) and PHQ-2 (cut-off point=3) were reliable and valid to detect major depression in Chinese patients with multiple somatic symptoms.
Language eng
DOI 10.1016/j.jad.2014.12.042
Field of Research 119999 Medical and Health Sciences not elsewhere classified
Socio Economic Objective 920499 Public Health (excl. Specific Population Health) not elsewhere classified
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2015, Elsevier
Persistent URL http://hdl.handle.net/10536/DRO/DU:30073466

Document type: Journal Article
Collection: School of Health and Social Development
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